Surgical table



July 27, 1965 J. s. COLLIS 3,197,198

SURGICAL TABLE Filed Feb. 18, 1963 3 Sheets-Sheet 1 4 INVENTOR JOHN S.COLLYS ATTORNEY J. s. COLLIS SURGICAL TABLE July 27, 1965 5 Sheets-Sheet2 Filed Feb. 18, 1963 B L L O C S N H O v ATTORNEY J. S. COLLIS SURGICALTABLE July 27, 1965 3 Sheets-Sheet 3 Filed Feb. 18, 1963 JOHN S. COLLISUnited States Patent 3,197,198 S'JRGEQAL TAELE Eohn S. Collie, Honolulu,Hawaii, assignor to Hahn V. Let/as, Lexington, Ky. Filed 18, 1%3, Ser.No. 259,169 '7 Claims. (1. 269-322) This invention relates to a surgicaltable and more particularly to such a table on which a patient is to besupported for spinal examination or operation.

In the treatment of patients by lumbar discography techniques thepatient-supporting table may be comparatively simple in construction, ascontrasted with tables used for other types of surgical work, butnevertheless, must satisfy certain essential requirements. Chief amongthese requirements are that while the patient is supported on the table,needles may be easily introduced into the lumbar discs, and that X-raysmay be made without removing the needles from the patient and that thetable construction be such that no interference is presented thereby tothe prompt and effective carrying out of these steps by the operator.Concomitant with these general requirements are the specificrequirements that the table provide for the patients back to bemaximally fiexed and that it oifer no obstruction to the taking of bothlateral and anteroposterior X-rays by means of a separate X-rayapparatus positioned adjacent the table. It is a purpose of my inventionto supply a surgical table which satisfies these requirements in animproved manner.

An object of the invention is to provide an improved and simplifiedsurgical table for use in lumbar discography examinations andoperations.

Another object is to provide an improved surgical table having astructure including a rigid framework and a patient-supporting top whichpositions the patient at a convenient operating height and with thepatients spine in maximally flexed condition.

Another object is to provide an improved surgical table having astructure including a rigid framework and patient-supporting top whichpermits the taking of lateral and anteroposterior X-rays of the patientsspine without moving the patient.

A further object is to provide an improved surgical table having anelevator for supporting the knees of the patient and for assisting inpositioning the patients body on the table top.

A still further object is to provide an improved surgical table havingan elevator for supporting the knees of the patient and with an improvedactuating means for the elevator.

Other objects and advantages will become apparent as the descriptionproceeds and when considered in conjunction with the accompanyingdrawings in which:

FIG. 1 is a perspective view of the table showing a patient supportedthereon as indicated by dotted lines.

FIG. 2 is a perspective view of the table when unoccupied, and takenfrom a different angle of View.

FIG. 3 is a front elevation view of the table with portions omitted andshowing diagrammatically the relation of the table, the patient, and afixed X-ray installation when an anteroposterior view of the patientsspine is being taken.

FIG. 4 is a front elevation view of the table with portions omitted andshowing diagrammatically the relation of the table, the patient and afixed X-ray installation when a lateral view of the patients spine isbeing taken.

FIG. 5 is a sectional view to a larger scale taken on line 55 of FIG. 2and showing the elevator carriage means, and

FIG. 6 is a sectional view to a larger scale taken on Blhllh PatentedJuly 27, 1965 line 6-6 of FIG. 2 and showing a portion of the elevatoractuating means.

Referring first to FIG. 2, my improved table includes a rigid frameworkwhich, by way of illustration and not of limitation, preferablycomprises a pair of identical side frame members which conveniently maybe formed of light weight tubular material such as aluminum alloy. Theright hand frame member, when referred to the direction in which thepatient is to be located, includes a forward leg 1%, a rearward leg 11,and an upper side rail 12 joining the upper ends of those legs and alower side rail 13. Likewise, the left hand frame member includessimilar legs and rails as seen at 14, iii, 16 and 17 respectively. Thelower side rails, which are substantially horizontal, are spaced at agenerous vertical distance from the upper side rails, thus, leaving alarge open space in the interior of the table. These lower side railsare attached at their forward ends to the lower portions of the forwardlegs and support the lower ends of the rearward legs which are aflixedto those lower rails intermediate the ends of those rails. Adjacenttheir projecting rearward ends, the lower rails are separated by aspacer tube 1%, attached thereto, and the forward legs of the framemembers are separated laterally by a similar spacer tube 19. Similarupper spacer tubes 2:) and 21 are located between the frame members andserve the additional purpose of helping to mount the table top, it beingnoted that the spacer tube 21 between the rearward legs is located abovethe path of travel of the carriage later to be described. Thethus-described framework preferably, but not necessarily, is mountedupon casters as shown at 22, 23, 2.4 and 2-5.

As a feature of the invention, the rearward legs are longer than theforward legs and are forwardly inclined from their attachments to thelower side rails. These rearward legs are straight throughout the majorportion of their length and merge with a smooth arcuate curve into theupper rails which are straight through a substantial portion of theirlength and then merge with an arcuate curve into the upper ends of theforward legs. Attached to these upper side rails and to the spacers 20and Z1, is a table top member, formed of any suitable material havingthe characteristics of being pervious to X-rays, gamma rays, or thelike; of being sufficiently strong to suport the weight of the patient;and of being readily cleaned and sanitary. Lucite, for example, is asuitable material for this purpose.

As will thus be noted, the table top includes a rearward skirt portion3'3, against which the upper thighs of the patient will rest, adownwardly inclined portion 31 against which the chest or" the patientwill rest, and an intermediate upwardly convex portion 32, upon whichthe pelvic region of the patient will rest. For the purpose ofpositioning the patients body into this operative position, a kneeelevator having a cushion 33 detachably afi'ixed to a planar, generallyrectangular, platform 34 is provided, the forward corners of thisplatformhaving downwardly extending guides 35, 36 attached thereto.Referring now to FlG. 5, the guide includes a central concave portion 3?adapted to hug the inner curved surface of leg 11 and with flat flanges38 and 39 projecting from this concave portion and lying in a planeinwardly offset from the central plane of leg. ii. in order to preventbinding of the platform carriage which travels in an inclined path alongthe rearward legs of the framework, friction reducing rollers as, 41 and42;, 43 are journalled in the respective flanges and are suitably spacedfrom each other to engage the curved sides of leg Ill and to resist thebending moment caused by the weight of the body of the patient. Theguide 36 is similarly constructed and has lower rollers 44, d5journalled in its fiat flanges 4 5, 47, as best seen in MG. 5.Completing the carriage is a horizontal rod 48 projecting through theflanges 3% and 47 of the two guides and attached thereto at its ends.

Various means for actuating the thusdescribed knee platform and itscarriage may be employed without departing from the broader aspects ofmy invention. A preferred form, however, which is characterized by itssimplicity and mechanical reliability may include a pair of elongatedracks and 51 which are pivotally mounted upon rod 4-3 immediatelyinboard of the flanges of the guides and which extend at their lowerends through gear boxes and 53 respectively. Rigidly affixed to thelower side rails adjacent the junction of the rearward legs therewithare a pair of upstanding brackets 54 and in which the ends of driveshaft are journalled for rotation in either clockwise orcounter-clockwise directions. As seen in FIG. 1, this shaft ispositioned to the left of the carriage guides as they move toward theirupward positions, thus providing an efficient lifting action by theracks as the weight of the patients body is moved forwardly by thetravel of the knee platform in its upward direction.

Each of the gear boxes 52 and 53 is pivotally mounted upon drive shaft56 and encloses the respective spur gears 57, 6) wlich are a tached to ttat shaft by splines and which are in mesh at all times with therespective racks. Loosely journalled upon the drive shaft adjacent itscenter is another gear box housing a worm wheel at attached to the shaftand which wheel is in engement at all times with a worm which in turn isaffixed to the end of an elongated rotatable rod 62. This rod isjournalled in a support plate 63 afiixcd to cross member (iiabove thelower side rails of the frat 1c and is manipulated by a hand wheel 65located adjacent the plane in which the forward legs of the table arelocated. it will be observed that rod 62 is located at the lower regionof the framework and is sufficiently far below the table top to leave agenerous open space beneath that table top interiorly of the framework.

With the foregoing in mind, reference now is made to FIGS. 3 and 4 andto the position occupied by the patient during a lumbar discographyexamination. Normally the unconscious patient will be first supportedwith his knees upon cushion 33 and his body arranged as generally shownin FIG. 1. Thereafter, the surgeon with the aid of an attendant,operating hand wheel 65, will eilect the optimum positioning of thepatients spine above the convex portion 32 of the table top at whichtime the spinal column will be maximally flexed and the patients backwill generally be parallel to the floor on which the casters of thetable are resting. Needles are then introduced into the lumbar discs,and the table is moved to the X-ray apparatus, which for example, maycomprise a conventional generating unit and a conventional recordingplate unit indicated generally by the dotted members and 67,respectively. These units may be supported from a wall by means ofsuitable adjustable arm linkages, or' the X-ray apparatus may itself bemovable as a whole and brought to the table. In eithe" event, ample openspace is provided beneath the top of the surgical table for receptionand proper positioning of the X-ray member 56 which may be swung underthe table top from either the right or left sides of the framework.Likewise, the patients body lies above the uppermost parts of the tableand the X-ray member 6'7 may be swung into proper position abovecompanion member 65, as when an anteroposterior view is to be recordedwith the needles in place. By the same token, when a lateral view is tobe taken, the table is spaced somewhat farther from wall d3 as indicatedin FIG. 4 and the linkage for X-ray member all is extended beneath thetable top while the linkage for member 67 is colla thus to positionthese mbers closely adiacent to the patients body and at the sides ofthe same. Any subsequent adjustment of the patients body after the X-rayapparatus has been brought into operative position, may be readilyeffected by raising or lowering of the knee platform and by manuallyassisting in bringing the patients body to the desired adjustedposition.

Various other advantages of the apparatus will be apparent to thoseskilled in the art. For example, the knee platform has a long range oftravel and is suitable for use with both adults and children; the widthof the table top is ample for supporting large patients comfortably andin the event that the patients body is not centered with respect to thelongitudinal center line of the table, the examination may still beconducted without lateral shifting of the body; and the arrangement by v'hich the knee platform travels along an upwardly ing rt a usefulforwardly directed component of force which urges the lower portion ofthe patients body into the desired position above the uppermost convexregion of the table top.

While I have illustrated and described a single embodiment of myinvention, it is to be understood that my invention may assume otherforms and that my invention includes all variations, modifications, andequivalents coming within the scope of the appended claims.

What 1 claim as new and desire to secure by Letters Patent of the UnitedStates, is:

1. in a surgical table for use in treating the spinal column of apatient, a framework comprising a pair of side frame members, eachmember including a forward leg, a forwardly inclined rearward leg longerthan said forward leg, an upper side rail joining the upper ends of saidlegs, and a lower side rail joining said legs adjacent the lower endsthereof, spacers attached to and extending between said side framemembers for holding said members laterally spaced from each other andforming a reinforced rigid framework; a table top extending between andattached to said upper rails and providing a support for the prone bodyof a patient, said table top having a convex surface adjacent thejunctions of said rearward legs and said upper rails for supporting thepelvic region of said patient in elevated position, an elevatorincluding a platform for supporting the knees of the patient, carriagemeans attached to said platform and movable along said rearward legs ofsaid framework, and means for actuating said carriage means and forefiecting Selective raising and lowering movements of said platform.

2. Apparatus as defined in claim 1 wherein said carriage means comprisesa pair of downwardly extending guides attached to the forward corners ofsaid platform, a rod extending between said guides for causing saidguides to move as a unit, and rollers mounted upon the respective guidesand engaging the respective rearward legs on opposite sides thereof; andsaid carriage actuating means includes a pair of elongated rackspivotally mounted at their upper ends upon said rod, a shaft mountedtransversely of said framework and having a pair of spur gears thereonmeshing with the respective racks, and means for selectively rotatingsaid shaft in either a clockwise or counterclockwise direction.

3. Apparatus as defined in claim 2 wherein said shaft is disposedadjacent the junction of said rearward legs and said lower side rails ofsaid framework.

Apparatus as defined in claim 2 wherein said carriage actuating means isdisposed Within the boundaries of said framework established by saidside frame memers thereof thereby to leave the lateral sides of saidtable unobstructed.

5. In a surgical table for use in treating the spinal column of apatient, a framework comprising a pair of side frame members, eachmember including a forward leg, a forwardly inclined rearward leg longerthan said forward leg, an upper side rail joining the upper ends of saidegs, and a lowerside rail joining said legs adjacent the lower endsthereof, said lower side rails being spaced from said upper side railswith a generous vertical space therebetween, spacers attached to andextending between said side frame members for holding said memberslaterally spaced from each other and forming a reinforced rigidframework; an X-ray pervious table top extending between and attached tosaid upper rails and providing a support for the prone body of apatient, said table top having a convex surface adjacent the junction ofsaid rearward legs and said upper rails for supporting the pelvic regionof said patient in elevated position above the remainder of the tableand with unobstructed spaces at the sides of the pelvic region of thepatient, an elevator including a platform for supporting the knees ofthe patient and adapted when actuated to move the patient and toposition the spinal column of the patient in flexed condition above saidconvex surface, carriage means attached to said platform and movablealong said rearward legs of said framework, and means for actuating saidcarriage means and for effecting selective raising and loweringmovements of said platform.

6. Apparatus as defined in claim 5 wherein said table top includes askirt portion for guiding the thighs of the patients body as the body isbeing elevated into position upon said table top, said skirt portionextending downwardly along said rearward legs from said convex surfaceand terminating above the uppermost point of movement of said carriagealong said rearward legs.

7. Apparatus as defined in claim 5 wherein said table top includes adownwardly directed chest-supporting portion extending forwardly fromsaid convex surface and terminating adjacent the junctions of said upperside rails and said forward legs of said framework.

References Cited by the Examiner UNITED STATES PATENTS ROBERT C.RIORDON, Primary Examiner.

1. IN A SURGICAL TABLE FOR USE IN TREATING THE SPINAL COLUMN OF APATIENT, A FRAMEWORK COMPRISING A PAIR OF SIDE FRAME MEMBERS, EACHMEMBER INCLUDING A FORWARD LEG, A FORWARDLY INCLINED REARWARD LEG LONGERTHAN SAID FORWARD LEG, AN UPPER SIDE RAIL JOINING THE UPPER ENDS OF SAIDLEGS, AND A LOWER SIDE RAIL JOINING SAID LEGS ADJACENT THE LOWER ENDSTHEREOF, SPACERS ATTACHED TO AND EXTENDING BETWEEN SAID SIDE FRAMAEMEMBERS FOR HOLDING SAID MEMBERS LATERALLY SPACED FROM EACH OTHER ANDFORMING A REINFORCED RIGID FRAMEWORK; A TABLE TOP EXTENDING BETWEEN ANDATTACHED TO SAID UPPER RAILS AND PROVIDING A SUPPORT FOR THE PRONE BODYOF A PATIENT, SAID TABLE TOP HAVING A CONVEX SURFACE ADJACENT THEJUNCTIONS OF SAID REARWARD LEGS AND